You are the F1 attached to the Stroke team.You see a 76 year old woman admitted with Left TACS 3 weeks ago.She is making a poor recovery, not engaging with physio/SALT/OT.Her oral intake has declined significantly over the past 2 weeks and she has been agitated and labile in mood on occasion.Physical parameters have remained stable.

What is the most likely diagnosis?Can you prescribe first line medication for this? What are the reasons behind your choice?

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In order to get some prescribing resources out there we intend to publish a series of prescribing problems on the website. The problems will appear at least weekly with the "answers" appearing a couple of days later. We'll use the standard exam stationery available on the LSE, but also available below in case you haven't got access to the LSE.

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